Degenerative disc disease (DDD) is known as osteoarthritis of the spine that causes a thinning of the discs and back pain. Many people are told they have this disease by their healthcare provider when presenting for something such as low back pain or sciatica, but this might not be true! We are learning now more than ever that DDD might not be anything to be afraid of, or even mention.
The original theory behind disc degeneration is that our spinal discs become thin and dried out and can no longer effectively shock absorb for the spine to allow free movement. What we know now is that although these radiographic changes are true, they are not always responsible for the way your back is feeling. This proposed the concept that this is not a disease, but rather normal.
Often, patients that are told they have degenerative disc disease carry this diagnosis around with them like heavy cargo limiting them from advancing forward. It makes them feel like they're fragile. It makes them feel like they can't lift weights and are often told they can't even lift weights or exercise or that they'll be limited in their function for potentially the rest of their life. This is such a fallacy and it's a shame to hear people are still hearing this from their healthcare providers. It drives me crazy and I'm sure it drives you crazy too because in actuality this disease is just normal age-related changes, right? WebMD's article on DDD recently changed to include "normal changes" in the definition. Everyone gets this "degenerative disc disease". Pretty much everyone over 30 years old gets this "disease", arthritis included! These are completely normal changes that everybody gets and just because you see this finding on imaging does not mean it's related to your pain or loss of function in any way.
This article states, "While the MRI scan represents a very sensitive and accurate assessment of spinal anatomy, it cannot distinguish between painful and non-painful structures in the spine. In fact, a patient may have severe back pain and an MRI scan that shows a relatively normal-looking spine, or conversely may have no back pain but the MRI scan reveals a lot of anatomical problems. Thus, the findings on MRI scans do not constitute a diagnosis and the MRI findings must be correlated with the patient’s physical exam and back pain symptoms to arrive at a clinical diagnosis."
Imaging can LIE!!!
These guidelines also apply to knee, shoulder, or neck pops and clicks as this joint noise can also be completely normal and unrelated to any pain or injury. Watch this video for more info on joint crepitus.
Many people that are diagnosed with DDD often received radiology showing spinal disc herniations, degeneration, stenosis, or other signs previously assumed to cause back pain but this is not true.
Ideally you would receive an assessment from someone that's trained in musculoskeletal care such as a chiropractor or physical therapist to determine what the cause of your symptoms is. Telling someone they have degenerative disc disease is like you telling your grandma that she has degenerative face disease. No one would say that because it would be silly! Starting to get my point? Just like we get wrinkles on our face, our bones spine and joints get these age related changes too. It comes with the grey hair. It comes with the extra candles on a birthday cake. It's nothing to be afraid of. Degenerative disc disease does not limit you, so do not accept this scary language from so many providers out there that are still considering this to be a legitimate disease. There's a paper from 2019 that has a great conclusion summary on this topic. It states "degenerative disc disease represents an underdeveloped concept, with greatly varying, disparate definitions documented. Such inconsistencies challenge clear, accurate communication in medicine and science, create confusion and misconceptions among clinicians, patients and others, and hinder the advancement of related knowledge." We've got to stop using these words and get this message out to patients and clinicians. Make it clear that this is not a scary disease and that the words we use and the labels that we put on people can have a much bigger impact than we could realize. Don't be afraid of these words.
Okay so i'm not afraid of DDD anymore, but now what?
We know that exercise is the best thing to achieve a healthy spine. Just like our muscles, when we exercise and load our spines tissue of bones and discs adapt by getting stronger and thicker. A couple exercises I like that are safe for many people diagnosed with DDD can be seen in this video.
How can I get a healthy and strong low back?
Ultimately, our bodies crave movement and exercise. Continuing to be active and exercise is the best thing we can do to have a healthy spine and prevent back pain in the future! The RehabFix Low Back Program was designed to take you step by step through the stages of recovery/prevention. By learning what movements are good for your back, how to do them, and how often with proper progressions is the best way for you to develop a bullet proof back. Get a bullet proof back!
I help people with low back issues recover without drugs or surgery through 1:1 online coaching.
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Thanks for reading. Share with a friend that needs to hear this message about their back!
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